<!DOCTYPE html>
<html>
<head>
    <title>更改挂号--中软高科-2015</title>
    <meta charset="UTF-8">
    <link rel="stylesheet" type="text/css" href="../Css/bootstrap.css"/>
    <link rel="stylesheet" type="text/css" href="../Css/bootstrap-responsive.css"/>
    <link rel="stylesheet" type="text/css" href="../Css/style.css"/>
    <script type="text/javascript" src="../Js/jquery.js"></script>
    <script type="text/javascript" src="../Js/jquery.sorted.js"></script>
    <script type="text/javascript" src="../Js/bootstrap.js"></script>
    <script type="text/javascript" src="../Js/ckform.js"></script>
    <script type="text/javascript" src="../Js/common.js"></script>
    <script type="text/javascript" src="../Js/ckeditor/ckeditor.js"></script>


    <style type="text/css">
        body {
            padding-bottom: 40px;
        }

        .sidebar-nav {
            padding: 9px 0;
        }

        @media (max-width: 980px) {
            /* Enable use of floated navbar text */
            .navbar-text.pull-right {
                float: none;
                padding-left: 5px;
                padding-right: 5px;
            }
        }


    </style>
    <script type="text/javascript">
        $(function () {
            $('#backid').click(function () {
                window.location.href = "index.html";
            });
        });
    </script>
</head>
<body>
<form id="myForm" class="definewidth m20">
    <table class="table table-bordered table-hover definewidth m10">
        <tr>
            <td width="10%" class="tableleft">姓名</td>
            <td><input type="text" name="name" value=""/></td>
        </tr>

        <tr>
            <td width="10%" class="tableleft">身份证号</td>
            <td><input type="text" name="idCard" value=""/></td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">挂号费</td>
            <td><input type="text" name="regPrice" value=""/>元</td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">社保号</td>
            <td><input type="text" name="medical" value=""/></td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">联系电话</td>
            <td><input type="text" name="phone" value=""/></td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">是否自费</td>
            <td><input type="radio" name="selfPrice" id="no" value="1" checked/>否&nbsp;&nbsp;&nbsp;<input type="radio"
                                                                                                          name="selfPrice"
                                                                                                          id="yes"
                                                                                                          value="0"/>是
            </td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">性别</td>
            <td><input type="radio" name="sex" id="nan" value="0" checked/>男&nbsp;&nbsp;&nbsp;<input type="radio"
                                                                                                     name="sex" id="nv"
                                                                                                     value="1"/>女
            </td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">年龄</td>
            <td><input type="text" name="age" value=""/></td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">职业</td>
            <td><input type="text" name="work" value=""/></td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">初复诊</td>
            <td><input type="radio" name="lookDoctor" id="first" value="0" checked/>初诊&nbsp;&nbsp;&nbsp;<input
                    type="radio" name="lookDoctor" id="second" value="1"/>复诊
            </td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">所挂科室</td>
            <td><select name="keShi">
                <option value="0">急诊科</option>
                <option value="1">骨科</option>
                <option value="2">血液科</option>
                <option value="3">外科</option>
            </select></td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">指定医生</td>
            <td><select name="doctorName">
                <option value="0">程俊</option>
                <option value="1">欧阳雨露</option>
                <option value="2">王博</option>
                <option value="3">沈青川</option>
            </select></td>
        </tr>
        <tr>
            <td width="10%" class="tableleft">备注</td>
            <td><textarea name="remark" id="remark"></textarea></td>
        </tr>
        <tr>
            <td colspan="2">
                <center>
                    <button id="add" class="btn btn-primary" type="button">保存</button> &nbsp;&nbsp;<button type="button"
                                                                                                           class="btn btn-success"
                                                                                                           name="backid"
                                                                                                           id="backid">
                    返回列表
                </button>
                </center>
            </td>
        </tr>
    </table>
</form>
</body>
</html>
<script>
    $(function () {
        //提交按钮的单击事件
        $("#add").click(function () {
            $.ajax({
                type: "POST",
                url: "/registration/",
                data: $("#myForm").serialize(),
                dataType: "json",
                success: function (vo) {
                    if (vo.code == 200) {
                        window.location.href = "index.html";
                    } else {
                        alert("添加失败！" + vo.msg);
                    }
                }
            });
        });
    });
</script>